Blood pressure and vascular determinants of glomerular filtration rate decline in diabetic kidney disease
© 2023 Truscello, Nobre, Sabaratnam, Bonny, Wuerzner, Burnier, Fakhouri, Pruijm and Zanchi..
Objective: In patients with type 2 diabetes and diabetic kidney disease (DKD), explore the relationship between estimated glomerular filtration rate decline (eGFR-d) and simultaneously assessed vascular risk markers including office, ambulatory or central blood pressure, pulse pressure, carotid-femoral pulse wave velocity (PWV), carotid intima-media thickness (IMT) and renal resistive indexes (RRI).
Research design and methods: At baseline, vascular risk markers were measured in addition to the routine clinical workup. The eGFR-d was based on 2000-2019 creatinine values. Parameters were compared by eGFR-d quartiles. Regression models of eGFR-d and vascular markers were assessed.
Results: In total, 135 patients were included. Mean age was 63.8 ± 10.8y, baseline eGFR 60.2 ± 26.4 ml/min/1.73 m2 and urine albumin-creatinine ratio (ACR) 49 ± 108 mg/mmol. Mean eGFR-d was based on 43 ± 39 creatinine values within a time span of 7.0 ± 1.9y. The average yearly eGFR decline was -1.8 ± 3.0 ml/min/1.73 m2 ranging from -5.8 ± 2.3 in the first quartile to +1.4 ± 1.7 in the fourth quartile. Mean 24 h systolic (SBP) and diastolic (DBP) blood pressure were 126 ± 17 and 74 ± 9 mmHg. Mean PWV was 11.8 ± 2.8 m/s, RRI 0.76 ± 0.07 and IMT 0.77 ± 0.21 mm. SBP and pulse pressure correlated with eGFR-d but not DBP. 24 h SBP stood out as a stronger predictor of eGFR-d than office or central SBP. PWV and RRI correlated with eGFR decline in univariate, but not multivariate regression models including 24 SBP and ACR.
Conclusions: In this study, eGFR decline was highly variable in patients with type 2 diabetes and DKD. Twenty-four hour SBP provided an added value to the routine measurement of ACR in predicting eGFR decline, whereas PWV and RRI did not.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
Frontiers in cardiovascular medicine - 10(2023) vom: 18., Seite 1230227 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Truscello, Luca [VerfasserIn] |
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| Links: |
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| Themen: |
Blood pressure |
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| Anmerkungen: |
Date Revised 09.11.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3389/fcvm.2023.1230227 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM360754953 |
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| 245 | 1 | 0 | |a Blood pressure and vascular determinants of glomerular filtration rate decline in diabetic kidney disease |
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| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2023 Truscello, Nobre, Sabaratnam, Bonny, Wuerzner, Burnier, Fakhouri, Pruijm and Zanchi. | ||
| 520 | |a Objective: In patients with type 2 diabetes and diabetic kidney disease (DKD), explore the relationship between estimated glomerular filtration rate decline (eGFR-d) and simultaneously assessed vascular risk markers including office, ambulatory or central blood pressure, pulse pressure, carotid-femoral pulse wave velocity (PWV), carotid intima-media thickness (IMT) and renal resistive indexes (RRI) | ||
| 520 | |a Research design and methods: At baseline, vascular risk markers were measured in addition to the routine clinical workup. The eGFR-d was based on 2000-2019 creatinine values. Parameters were compared by eGFR-d quartiles. Regression models of eGFR-d and vascular markers were assessed | ||
| 520 | |a Results: In total, 135 patients were included. Mean age was 63.8 ± 10.8y, baseline eGFR 60.2 ± 26.4 ml/min/1.73 m2 and urine albumin-creatinine ratio (ACR) 49 ± 108 mg/mmol. Mean eGFR-d was based on 43 ± 39 creatinine values within a time span of 7.0 ± 1.9y. The average yearly eGFR decline was -1.8 ± 3.0 ml/min/1.73 m2 ranging from -5.8 ± 2.3 in the first quartile to +1.4 ± 1.7 in the fourth quartile. Mean 24 h systolic (SBP) and diastolic (DBP) blood pressure were 126 ± 17 and 74 ± 9 mmHg. Mean PWV was 11.8 ± 2.8 m/s, RRI 0.76 ± 0.07 and IMT 0.77 ± 0.21 mm. SBP and pulse pressure correlated with eGFR-d but not DBP. 24 h SBP stood out as a stronger predictor of eGFR-d than office or central SBP. PWV and RRI correlated with eGFR decline in univariate, but not multivariate regression models including 24 SBP and ACR | ||
| 520 | |a Conclusions: In this study, eGFR decline was highly variable in patients with type 2 diabetes and DKD. Twenty-four hour SBP provided an added value to the routine measurement of ACR in predicting eGFR decline, whereas PWV and RRI did not | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a blood pressure | |
| 650 | 4 | |a carotid intima-media thickness | |
| 650 | 4 | |a diabetic kidney disease | |
| 650 | 4 | |a pulse wave velocity | |
| 650 | 4 | |a renal resistive index | |
| 700 | 1 | |a Nobre, Dina |e verfasserin |4 aut | |
| 700 | 1 | |a Sabaratnam, Vehashini |e verfasserin |4 aut | |
| 700 | 1 | |a Bonny, Olivier |e verfasserin |4 aut | |
| 700 | 1 | |a Wuerzner, Grégoire |e verfasserin |4 aut | |
| 700 | 1 | |a Burnier, Michel |e verfasserin |4 aut | |
| 700 | 1 | |a Fakhouri, Fadi |e verfasserin |4 aut | |
| 700 | 1 | |a Pruijm, Menno |e verfasserin |4 aut | |
| 700 | 1 | |a Zanchi, Anne |e verfasserin |4 aut | |
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